Management of Gallstones and Acute Cholecystitis in Patients with Liver Cirrhosis: What Should We Consider When Performing Surgery?

Management of Gallstones and Acute Cholecystitis in Patients with Liver Cirrhosis: What Should We Consider When Performing Surgery? Gut Liver. 2020 Sep 15;: Authors: Wang SY, Yeh CN, Jan YY, Chen MF Abstract Acute cholecystitis and several gallbladder stone-related conditions, such as impacted common bile duct stones, cholangitis, and biliary pancreatitis, are common medical conditions in daily practice. An early cholecystectomy or drainage procedure with delayed cholecystectomy is the current standard of treatment based on published clinical guidelines. Cirrhosis is not only a condition of chronically impaired hepatic function but also has systemic effects in patients. In cirrhotic individuals, several predisposing factors, including changes in the bile acid composition, increased nucleation of bile, and decreased motility of the gallbladder, contribute to the formation of biliary stones and the possibility of symptomatic cholelithiasis, which is an indication for surgical treatment. In addition to these predisposing factors for cholelithiasis, systemic effects and local anatomic consequences related to cirrhosis lead to anesthesiologic risks and perioperative complications in cirrhotic patients. Therefore, the treatment of the aforementioned biliary conditions in cirrhotic patients has become a challenging issue. In this review, we focus on cholecystectomy for cirrhotic patients and summarize the surgical indications, risk stratification, surgical proce...
Source: Gut and Liver - Category: Gastroenterology Tags: Gut Liver Source Type: research

Related Links:

In this study, an attempt to oxidise the surface of a commercial activated carbon to improve its adsorption capacity for sevoflurane was conducted using 6 mol/L nitric acid, 2 mol/L ammonium persulfate, and 30 wt per cent (wt%) of hydrogen peroxide (H2O2). The adsorption tests at fixed conditions (bed depth: 10 cm, inlet concentration: 528 mg/L, and flow rate: 3 L/min) revealed that H2O2 oxidation gave desirable sevoflurane adsorption (0.510 ± 0.005 mg/m2). A parametric study was conducted with H2O2 to investigate the effect of oxidation conditions to the changes in surfa...
Source: Chemosphere - Category: Chemistry Authors: Tags: Chemosphere Source Type: research
ConclusionAS/AD is a mechanical disorder of the larynx that can be successfully treated if promptly diagnosed. Clinical trials and multi-centric studies are necessary to set management guidelines.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
Publication date: Available online 9 October 2020Source: Journal of Pharmacological SciencesAuthor(s): Hiroyuki Saito, Ryuichi Kambayashi, Mihoko Hagiwara-Nagasawa, Yoshio Nunoi, Ai Goto, Hiroko Izumi-Nakaseko, Shinichi Kawai, Yoshinori Takei, Akio Matsumoto, Kiyotaka Hoshiai, Yasuki Akie, Atsushi Sugiyama
Source: Journal of Pharmacological Sciences - Category: Drugs & Pharmacology Source Type: research
CONCLUSION: The ultrasonography measure of right liver lobe diameter by itself can reliably identify patients with NAFLD with a good sensitivity and specificity, however, this can be improved by adding the LAP mathematical index in our population. PMID: 33031969 [PubMed - as supplied by publisher]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Authors: Li M, Guo Z, Zhang D, Xu X, Romeiro FG, Mancuso A, Zhang J, Feng R, Zhou X, Hong C, Qi X Abstract Methods: Cirrhotic patients who were consecutively hospitalized between January 2016 and March 2019 were screened. Serum cardiac biomarkers at admission, including N-Terminal pro-B-type natriuretic peptide (NT-pro BNP), high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase (CK), creatine kinase MB (CK-MB), and lactate dehydrogenase (LDH), were collected. Acute decompensating events at admission, primarily including ascites, acute gastrointestinal hemorrhage, and acute-on-chronic liver failure (ACLF), ...
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
Discussion Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane receptor (CFTR). It is found in the epithelium of the bronchi, intestine, pancreatic duct and biliary tree. It regulates chloride, bicarbonate and water secretion. The heterozygous state helps prevent against secretory diarrhea, but the homozygous state causes thickened secretions in the hollow tubes of the lungs and digestive tract. There are multiple mutations (> 2000) which have been currently classified into classes depending on their protein production and activity. CF patients generally are l...
Source: - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Obesity is usually associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause [e.g. non-alcoholic fatty liver diseases (NAFLD)] or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease (GERD), erosive esophagitis, Barrett...
Source: Gastroenterology - Category: Gastroenterology Authors: Source Type: research
ConclusionThe study concluded safety of total clipless laparoscopic cholecystectomy using a harmonic scalpel in Child A and B type cirrhotic patients, who presented with complicated gallstones.
Source: ANZ Journal of Surgery - Category: Surgery Authors: Tags: Original Article Source Type: research
CONCLUSION: CP was associated with increased risk of subsequent PLA. The risk of PLA was higher in patients with five or more comorbidities. PMID: 27892720 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Conclusion There are little data to date on splenic vein stenting in the setting of EPH secondary to non-malignant pancreatic disease. We report a case managed successfully with splenic vein stenting and review the existing literature.
Source: Irish Journal of Medical Science - Category: Journals (General) Source Type: research
More News: Anesthesia | Anesthesiology | Bile | Cholecystectomy | Cirrhosis | Gallstones | Gastroenterology | Liver | Pancreatitis | Urology & Nephrology